Q&A with Psychologist, David Sabine, PhD
Q: What is your current position?
I'm a clinical psychologist in private practice in Wichita Falls, Texas.
Q: Can you describe private practice?
My work consists of doing both psychotherapy and neuropsychological testing, in which we have a diagnostic question. We do testing to try to answer that question. Sometimes it's about a problem relating to pressure or anxiety. Sometimes it might be related to brain behavior like a head injury or a seizure.
Q: How did you get started in this field and what kind of preparation does someone pursuing this career need?
I started out first as a pastor in the inner city. As I was working with some of the folks there, things came up that I just didn't have answers for. Those questions began to roll around in my head and led me to a real interest in human behavior and why people behave the way they do. So, I decided to pursue it in my education.
Q: What does a PsyD or PhD allow you to do?
The term psychologist is so broad. [It includes many different paths] from academia to clinical work and research. But, what distinguishes the psychologist is training, especially with regard to assessment and diagnosis. The doctoral degree allows you to perform psychological tests like I.Q. tests, academic measures, and projective measures like the Rorschach inkblot test, which involve more sophisticated abilities of interpretation.
Q: What traits are important for psychologists?
First, they need to have a natural proclivity for the verbal world. They have to be able to communicate verbally and be able to carry on conversations comfortably with others in a way that engages them and helps them to disclose and open up about their lives.
Second, I think you have to be psychologically minded. You have to think about, and be curious about, what makes us tick and why we do the things we do.
Thirdly, I would say you need to be able to enter into another's suffering in a way that they feel you're with them, connected to them, and committed to stay with them until they find some answers to whatever that problem is.
Q: How can a new psychologist learn to keep his/her sense of self?
I think a lot of new therapists wonder, "How's it going to be? Am I going to be able to handle it?" But, you get a lot of support. You're going to have a supervisor who's going to be very close with you, working with you at those points at which you feel emotionally over-involved with your client.
It is a critical skill to be able to be with someone, empathize with him or her, and at the same time not be pulled into that personally in a way that depletes your own resources.
Interestingly, after 15 years of doing this you would think that I might be cynical about human nature, but in fact, I'm more optimistic and positive about us as human beings than ever. And, it's because of the heroic work of my clients. The big surprise - and the great surprise - is that you often find yourself encouraged and enthused about life because of that.
Q: What are some of the challenges that psychologists in the field today face?
There are a number of challenges. One would be the issue of third-party reimbursement. Some psychologists have said, "OK, I'm done with that, I'm just going to do fee-for-service." There are all types of documentation expectations, standards and ethical practices that we have to keep up all the time. There are a lot of people that look over your shoulder even though it's a very private meeting with somebody else. There are many people that we are accountable to, and that's good because it protects the client. But, it nevertheless is a burden sometimes because of the detail needed to carry on the practice.
Q: What kinds of changes have there been in your area of practice in the last few years?
We've been through dramatic changes from the time I started 15 years ago. Managed care was just becoming prominent. It seemed like managed care was going to take over everything, and then every single service a psychologist would be doing would be watched over by a company. That wave passed. Now, under health care reform, insurance companies need to be able to detect fraud and waste and make sure that people are getting good quality services. So, that's another layer of oversight we have to deal with, but a necessary one.
The other side of the coin is that it appears that many more people are going to come into the mental health care system. That's going to [create] a greater demand - I think that's our next big challenge.
Q: What should students ask themselves before entering the field?
First, are you comfortable with a certain measure of chaos in your life? You have to have an affinity for chaos in some ways to do this. When you get into practice, you need to be comfortable with change; you need to feel that you have the skills and confidence to access [whatever resources you need]. Somebody who wants a great measure of safety and consistency can still work in psychology but probably for an organization.
For those that have the more entrepreneurial spirit, the private practice world opens up. If you want to do private practice, do you have interest in business? Many [psychologists] don't think of themselves as business people; they think of themselves as clinicians, but you have to have skills in business, marketing, and networking [as well].
Q: Any other recommendations for aspiring psychotherapists?
I believe that every human labor has value and is meaningful, but there are few professions in which that connection is as immediate as in the work of psychotherapy. We often live our lives wondering about what's going on with that other guy and what other people feel, but the psychologist knows that. We have a chance to make a difference in the world. And, for me, that makes it all worthwhile. It gets me up in the morning and makes me feel as if I'm contributing in a meaningful way. So my hat's off to anybody who gets into [psychology]. If you think you have that set of skills and those interests, then this might be a wonderful way to spend your life work.